By: Sharath Joji  Apr. 07, 2021

Overlook Medical Center, Summit, NJ, reported a CMS Value Based Purchasing (VBP) Adjustment Factor of 0.9956 in the year 2021, which could result in an estimated penalty of $334,620. Medicare Spending Per Beneficiary (MSPB) accounts for 25% of overall VBP score and is a significant factor in driving VBP payments. MSPB costs include the costs from 3 days before hospitalization, index hospital stays, and 30 days post-discharge. The measure score of the Efficiency & Cost Reduction domain for Overlook Medical Center during the period was 1/10. Dexur is an approved purchaser of CMS Medicare claims data and based on our simulator, we estimate that Overlook Medical Center can avoid VBP penalties by reducing MSPB Costs by 4.8%.

By: Barsha Nandy  Jul. 27, 2020

Dexur’s analysis of medicare claims of hospitals within a 10-mile radius of Summit, NJ, showed that Overlook Medical Center, Morristown Medical Center, and Robert Wood Johnson University Hospital Rahway had the best value outcomes over a 90 day episode for Sepsis. Dexur’s value analysis tracks a patient’s episode of care from the date of admission for 90 days and includes the index hospitalizations, rehospitalization, home health, nursing home, and ED costs. Total cost of care data helps patients make appropriate choices and helps local ACOs, such as Optimus Healthcare Partners, LLC, make appropriate referral choices. The analysis was risk-adjusted, for alive and non-hospice patients and was done at the DRG level, specifically DRG 871: Septicemia or Severe Sepsis without MV >96 Hours with Major Complication or Comorbidity, to adjust for complications and comorbidities.

By: Barsha Nandy  Jul. 20, 2020

Dexur’s analysis of medicare claims of hospitals within a 10-mile radius of Montclair, NJ, showed that Overlook Medical Center, Trinitas Regional Medical Center, and Mountainside Medical Center had the best value outcomes over a 90 day episode for Sepsis. Dexur’s value analysis tracks a patient’s episode of care from the date of admission for 90 days and includes the index hospitalizations, rehospitalization, home health, nursing home, and ED costs. Total cost of care data helps patients make appropriate choices and helps local ACOs, such as Barnabas Health Care Network and Mission Health Coordinated Care, make appropriate referral choices. The analysis was risk-adjusted, for alive and non-hospice patients and was done at the DRG level, specifically DRG 871: Septicemia or Severe Sepsis without MV >96 Hours with Major Complication or Comorbidity, to adjust for complications and comorbidities.

By: Barsha Nandy  May. 18, 2020

Dexur’s analysis of medicare claims of hospitals in Northern Jersey showed that Overlook Medical Center, St. Luke's Warren Hospital, and Hackensack Meridian Health Pascack Valley Medical Center had the lowest cost of care over a 90-day episode for Heart Failure. The episode of care tracks a patient journey from the date of admission for 90 days includes the index hospitalizations, rehospitalization, home health, nursing home, and ED costs. The total cost of care helps patients make appropriate choices and helps local ACOs such as Meridian Accountable Care Organisation, JFK Health ACO, and Rihmond Quality to make appropriate referrals choices. The analysis was risk-adjusted and was done at the DRG level, specifically DRG 291: Heart Failure And Shock With Major Complication Or Comorbidity.